Is the increase in type III collagen of the patellar tendon graft after ligament reconstruction really caused by “ligamentization” of the graft?

Tohyama, Harukazu; Yasuda, Kazunori; H, Uchida

doi:10.1007/s00167-006-0092-z

Cited by 24 publications

(21 citation statements)

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“…The autograft underwent necrosis, revascularization and remodelling over time. Return of overall graft integrity and histological appearance was completed 6–12 months after reconstruction without full restoration of the mechanical strength of the intact ACL [4, 8, 25, 26, 31]. Grafts approached only 50–60% of the intact ACL failure strength [1, 13, 20, 31].…”

Section: Discussionmentioning

confidence: 99%

Remodelling of human hamstring autografts after anterior cruciate ligament reconstruction

Janssen

Wijk

Fiedler

et al. 2011

Knee Surg Sports Traumatol Arthrosc

113

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PurposeHistological analysis of the remodelling process of human hamstring tendon (HT) grafts after standardized anterior cruciate ligament reconstruction (ACLR) with an accelerated rehabilitation protocol.MethodsSixty-seven patients underwent retrieval of mid-substance biopsies after clinically successful hamstring autograft ACLR. Samples were allocated to one of three groups depending on the time point of retrieval: group 1 (6–12 months; n = 15), group 2 (13–24 months; n = 16) and group 3 (>24 months; n = 11).Biopsies from native HT (n = 17) and ACL (n = 8) served as controls. Cellular density, vascular density and myofibroblast density and collagen fibril alignment were analysed by haematoxylin–eosin, Masson-Goldner-Trichrom and immunohistochemical staining protocols.ResultsCompared with native HT (330.4/mm²), total cell number was increased in groups 1-3 (Group 1 = 482.0/mm² (P = 0.036); group 2 = 850.9/mm² (P = 0.005); and group 3 = 595.6/mm² (P = 0.043). There were no significant differences between the groups for vessel density. Myofibroblast density was higher in group 2 (199.6/mm²) compared with native HT (1.9/mm², P = 0.014). Collagen orientation was irregular up to 12 months. Thereafter, collagen orientation became more regular, adapting to, but not fully restoring, the appearance of the intact ACL. For the first 12 months, cells were predominantly ovoid. Ensuing cell morphology changed to spindle shaped in group 2 and predominantly narrow long cells over 24 months.ConclusionHuman hamstring grafts showed typical stages of graft remodelling, which was not complete up to 2 years after ACLR. The remodelling process in humans was prolonged compared with the results obtained in several animal studies. Level of evidenceCase–control study, Level III.

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Section: Discussionmentioning

confidence: 99%

Remodelling of human hamstring autografts after anterior cruciate ligament reconstruction

Janssen

Wijk

Fiedler

et al. 2011

Knee Surg Sports Traumatol Arthrosc

113

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“…La fibronectina aumenta la unión de las fibras de colágeno entre sí y con las fibras musculares [98]. Algunos autores han descrito la presencia de colágeno tipo III y I después de la lesión en contraste con la predominancia del tipo I en los ligamentos no lesionados [228]. Durante la remodelación del injerto la plastia pierde resistencia mientras se reorganiza estructuralmente.…”

Section: Fase Inicialunclassified

“…Otros autores relacionan el aumento de vasos [246] y la infiltracion extracelular [228] con la disminución de las propiedades mecánicas de la plastia. Estos hallazgos avalan otros muchos trabajos que encuentran que las propiedades mecánicas son mínimas en la fase de proliferación del injerto, aproximadamente entre la 6ª y 8ª Es un proceso de debilitamiento de la plastia hasta la 6ª semana que por otra parte mejora la integración del injerto en la plastia.…”

Section: Fase Inicialunclassified

“…Estos hallazgos avalan otros muchos trabajos que encuentran que las propiedades mecánicas son mínimas en la fase de proliferación del injerto, aproximadamente entre la 6ª y 8ª Es un proceso de debilitamiento de la plastia hasta la 6ª semana que por otra parte mejora la integración del injerto en la plastia. Este debilitamiento se acompaña de alteraciones del injerto que puede estar relacionado con la falta de movilidad inicial [228][189].…”

Section: Fase Inicialunclassified

“…La expresión de colágeno I y III están presentes en el ligamento inmaduro y en la cicatriz ligamentosa y está sobreexpresada en el proceso de remodelación e incorporación de las plastias de LCA [8] [228]. Las integrinas también pueden responder en función del ciclo de deformación.…”

Section: Fijación Del Injertounclassified

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Integración tendinosa de plastias autólogas en túneles de diferente calibre. Estudio experimental en ovejas

Hidalgo

Forriol

2012

Revista Española de Cirugía Ortopédica y Traumatología

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Diffusion Tensor Imaging for Quantitative Assessment of Anterior Cruciate Ligament Injury Grades and Graft

Liu

Chen

et al. 2020

Magnetic Resonance Imaging

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Background As the need for quantitative assessment of anterior cruciate ligament (ACL) injuries and ACL graft increases, diffusion tensor imaging (DTI) becomes a more valuable measuring tool. However, DTI changes in differing injury grades of ACL and longitudinal graft remain unclear. Purpose To investigate the diagnostic performance of DTI in quantitatively assessing ACL injury severity and the development of ACL grafts within 6 months of surgery. Study Type A cohort study. Subjects Thirty‐five patients diagnosed with grades I–IV ACL injuries and 20 volunteers as controls were recruited. Field Strength/Sequence T1‐weighted, T2‐weighted, proton density (PD)‐weighted, and DTI at 3.0T MRI. Assessment ACL injury grades in arthroscopic images and DTI quantitative data were evaluated from July 2016 to July 2018. Statistical Tests Chi‐square test, analysis of variance, Spearman correlation analysis, and receiver operator characteristic (ROC) curves. Results Both fractional anisotropy (FA) (r = −0.898, P < 0.05) and apparent diffusion coefficient (ADC) (r = 0.851, P < 0.05) were significantly correlated with the severity of ACL injuries. The area under the curve (AUC) values for differentiation between low‐ and high‐grade ACL injuries with FA and ADC were 0.973 and 0.963, respectively. Although there were no significant differences in FA (P > 0.05) and ADC (P > 0.05) between grades I and II ACL injuries or in ADC (P > 0.05) between grades III and IV, there were significant differences in FA and ADC between two grades (P < 0.05). There were significant differences in FA (P < 0.05) and ADC (P < 0.05) between normal ACL and 3‐month graft postoperation, as well as in ADC values between 3‐month and 6‐month graft postoperation (P < 0.05). Data Conclusion DTI could be used to quantitatively evaluate the ACL injury grades and the development of ACL grafts. The diagnostic efficiency of FA values was higher than that of ADC values. Level of Evidence 1 Technical Efficacy Stage 3

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Is the increase in type III collagen of the patellar tendon graft after ligament reconstruction really caused by “ligamentization” of the graft?

Cited by 24 publications

References 24 publications

Remodelling of human hamstring autografts after anterior cruciate ligament reconstruction

Remodelling of human hamstring autografts after anterior cruciate ligament reconstruction

Integración tendinosa de plastias autólogas en túneles de diferente calibre. Estudio experimental en ovejas

Diffusion Tensor Imaging for Quantitative Assessment of Anterior Cruciate Ligament Injury Grades and Graft

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